台灣地區生活功能獨立程度量表的結構分析研究

A Study on Structural Analysis of Functional Independence Measure in Taiwan

郭乃文(Nai-Wen Guo) ； 葉淑惠(Shu-Hui Yeh) ； 林昭宏(Jau-Hong Lin) ； 陳信穎(Hsin-Ying Chen) ； 劉景寬(Ching-Kuan Liu) ； 阮慧沁(Hui-Shin Yuan) ； 余麗樺(Li-Fa Yu) ； 陳惠姿(Huey-Tzy Chen)

《中華民國復健醫學會雜誌》 27卷4期 (1999/12) Pp. 217-226

摘要

本研究以民國八十四年至八十七年在台灣地區分別獨立進行的三個研究中的872個個案為樣本，進行對生活功能獨立程度量表（FIM）的結構考驗。樣本分別來自十三個護理之家家民、某教學醫院之神經內外科門診患者，以及復健科患者。以主軸法因素分析與Rasch模式分析，都證實這幾個研究中的FIM的確擁有兩個因素，第一因素『動作功能』有十三項，第二因素『認知功能』有五項。但在Rasch模式分析中，發現動作功能的十三項分數較不能符合項目間具可加成性的假設。並發現在台灣各題項的相對難度與Heinemannm（1993）和Linacre（1994）的研究略有出入，顯示生活功能測量工具受到跨文化因素的影響，值得注意。另外發現，FIM各題項間的內部一致性相關過高，根據逐步複回歸分析的結果僅用十一項的短式評估即可估計十八項分數的99.5百分比的分數變異量，因此在台灣使用FIM可能重複擴大某些題項訊息。最後考驗此短式的結構，並以相關分析呈現此短式FIM具有取代全版FIM的可行性。

關鍵字

生活功能獨立程度量表 ； 跨文化使用 ； 結構分析

並列摘要

A total of 827 Functional Independence Measure (FIM) scores, which from three separate cohorts research from 1995 to 1998 in Taiwan, were conducted the structural analysis of FIM. The 872 subjects included residents of nursery center, outpatients of neurology and neuro-surgery clinics as well as inpatients and outpatients of rehabilitation department. Both principle factor analysis and Rasch model analysis were able to identified two major factors of FIM in Taiwan. There were thirteen items in the first factor which was named as motor function factor, and five items in the second factor which was named as cognitive function factor. From our results, the FIM in Taiwan differed from the original FIM in item calibration, according to Rasch model analysis. Differences were observed in cross-culture usage of tools for measuring activity of daily life. Since there were high inter-item consistence, stepwise multiple regression were applied to establish a short measure form. The form included only eleven items but it was demonstrated to correlate well with the eighteen items in the original FIM. It seems to us that some redundant information is included in the FIM when it is clinically applied in Taiwan and, consequently, it should be carefully evaluated for the potential problems.

並列關鍵字

Functional Independence Measure ； FIM ； construct validity ； cross-culture usage